Sex Therapy: Female Orgasmic Disorder and Male Orgasmic Disorder
August 3, 2008 – 9:56 pm
Portraits
Her whole life, Diane has never experienced a sexual problem—until now. Since menopause started her sex drive has taken a nose dive. Worse yet, when she is in the mood, her pleasure place feels like dead space.
Rob has been battling depression for a few months. Lately his mood has improved, but his sex life is still in the dumps. He asks, “I can become aroused, but I can’t orgasm. Could this be because of the antidepressants?”
Beth is a newlywed, exploring her sexuality for the first time. It’s a frustrating experience for her to become so sexually aroused and not experience a release. She wants to know what she and her husband can do help her “finish.”
Definitions and Key Thoughts
Orgasmic disorder is a condition in which an individual is unable to climax sexually (i.e., have an orgasm), or when climax is severely delayed to the point which it causes psychological distress for one or both sexual partners. With male and female orgasmic disorder, the absence or delay of orgasm occurs after long and intense sexual stimulation.
With female orgasmic disorder, a woman may report that when orgasms occur, the climax is of a lesser quality than was has been previously experienced in the past—being less intense and feeling more localized. Some women with female orgasmic disorder has described that their clitoris “feels dead.”
Male orgasmic disorder is not to be confused with premature ejaculation, which is a sexual disorder involving an orgasm that occurs too early during sexual intercourse. The inability to climax is a problem more common with women, compared to men.
Some women who experience a delayed or absent orgasm lack climax because they or their sex partner do not sufficiently stimulate the woman’s clitoris. The amount and type of physical stimulation necessary for orgasm varies widely between women. For instance, only about one-half of women will reach orgasm during sexual intercourse, and many women require oral or manual (hand) stimulation of the clitoris to reach orgasm during sex.
Educating the woman and the woman’s sexual partner about sexual stimulation and female sexual anatomy will often decrease the symptoms, or resolve the issue completely, of female orgasmic disorder.
Common Causes of Orgasmic Disorder
Medication or Drug Side Effects
A number of medications can cause delayed or absent climax. Medication side effects are often a cause of orgasmic disorder symptoms, especially in men. Drugs that effect orgasm include:
- Alcohol
- High blood pressure medications
- Antidepressants (MAOIs or SSRIs)
- Anti-anxiety medications (such as benzodiazepines)
- Narcotics or Amphetamines
Trauma from Sexual Abuse
Statistics show that persons who have had a traumatic sexual experience, such as sexual abuse, are more susceptible to having sexual disorders, including orgasmic disorder.
Menopause
Menopause is a time of hormonal change in women. Sex hormones, such as estrogen and testosterone, are particularly affected during menopause. The physical changes during menopause can also cause decreased clitoral sensitivity, which can delay climax during sex and necessitate increased clitoral stimulation.
Sexual Surgery
Female surgeries involving the pelvic region, a hysterectomy, or the removal or ovaries can cause female orgasmic disorder due to the possible damage or severing of nerves (which decreases the feeling of sexual stimulation), to hormonal changes that often take place after the surgery.
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Action Steps and Treatment for Orgasmic Disorder
Understanding Sexual Anatomy and Physiology
Understanding anatomy is especially important when addressing female orgasmic disorder. While male sexual stimulation is generally an obvious and simple, female sexual stimulation involves finding a small area of the vagina known as the clitoris.
It is not always the male who does not understand female anatomy. A woman can become more in-tune with her anatomy and sexual sensations as well. Understanding what is sexually pleasing, and what is not sexually pleasing, will help a woman communicate to her partner what will lead her toward orgasm.
Drug and Hormone Therapy
Consulting with a medical doctor can be helpful in the treatment of orgasmic disorder. Sexual hormones such as estrogen and testosterone have been found to help with orgasmic function.
Also, since a number of medications have sexual side effects, altering the dosage of, or changing, a medication that is being taken can improve orgasm function.
Apply Additional Stimulation
Orgasmic disorder can be eased with additional sexual foreplay. Non-sexual intercourse type-stimulation (oral or manual) that is directly applied to the area around the clitoris is often effective in producing an orgasm. In addition, the use of an electric vibrator is often an effective method of producing an orgasm with woman. Note: be sure that both sexual partners discuss and are comfortable with the introduction of a vibrator or any sexual “toy” before such a devise is introduced.
Counseling and Psychotherapy
Counseling can be effective in the treatment of orgasmic disorder by addressing any emotional issues behind the inability to achieve an orgasm. Common emotional issues that interfere with orgasm include depression, stress and anxiety, and past sexual trauma.
In addition, couples with present relationship problems often experience sexual difficulties. By improving one’s relationship through couples counseling, symptoms of orgasmic disorder could dissipate.
Thrive Boston Counseling and Boston Psychotherapy offers sex therapy services to person suffering from sexual problems including male and female orgasmic disorder. Call 617-513-5433 for more information on Boston counseling services, or visit www.thriveboston.com
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